A Clinical Study of Children Who Showed Benign
Hemophagocytic Histiocytes in Bone Marrow Examination

Park, Jin A; Park, Joo Young; Park, Ji Min; Park, Seat Byoul; Kim, Heung Sik; Jeon, Dong Seok

Original Article

Journal of the Korean Pediatric Society 2002;45(8):1007-1015.
Published online August 15, 2002.

A Clinical Study of Children Who Showed Benign Hemophagocytic Histiocytes in Bone Marrow Examination

Jin A Park¹, Joo Young Park¹, Ji Min Park¹, Seat Byoul Park¹, Heung Sik Kim¹, Dong Seok Jeon²

¹Department of Pediatrics, Keimyung University, School of Medicine, Daegu, Korea
²Department of Clinical Pathology, Keimyung University, School of Medicine, Daegu, Korea

골수 검사상 양성 혈구 탐식 조직구가 나타난 소아의 임상적 고찰

박진아^¹^, 박주영^¹^, 박지민^¹^, 박샛별^¹^, 김흥식^¹^, 전동석^²

^¹계명대학교 의과대학 소아과학교실
^²계명대학교 의과대학 임상병리학교실

Correspondence:
Heung Sik Kim, Email: kimhs@dsmc.or.kr

Abstract

Purpose
: The aim of this study is to find a method to diagnose and treat children who showed benign hemophagocytic histiocytes in bone marrow examination.
Methods
: We analyzed the clinical data of thirty patients retrospectively who showed benign hemophagocytic histiocytes in bone marrow examination from January 1995 to November 2001 at Keimyung University Dong-san Hospital. Bone marrow histiocytes were classified into a few, some, and many according to the number of histiocytes comparing with the white cells.
Results
: The age of thirty patients ranged from two months to 15 years. The median age was 5.6 years with male predominance(2.3 : 1). The most frequent clinical manifestation was fever; others were respiratory symptom, hepatosplenomegaly, lymphadenopathy and skin rash(in order of frequency). Common laboratory findings were leukopenia, thrombocytopenia, anemia and abnormal liver function test. Infection was present in 30 patients; causative organisms were documented in 15 patients, and bacterial infection was more common. Epstein Barr virus was the cause of infection in four patients. Bone marrow examination showed a few(20.0%), some(75.0%) and many(30.0%) hemophagocytic histiocytes. Combination immunochemotherapy including immunoglobulin, steroids and cyclosporine were helpful in 22 out of 30 patients. The mortality rate was high in young patients who showed some to many hemophagocytic histiocytes.
Conclusion
: Bone marrow examinations and early detection of histiocytes will be helpful in children who have fever, hepatosplenomegaly and abnormal liver function test. Immunochemotherapy were helpful and further investigation will be needed for the detection of the relationship between the bone marrow findings and prognosis.

Key Words: Benign hemophagocytic histiocytes, Bone marrow examination